Many adolescent females are receiving the human papillomavirus, or HPV, vaccine, despite the lack of a mandate in any state to do so.

The HPV vaccine is given in a series of three doses and the best way to get protected is to complete all three doses before becoming sexually active.

In 2010, 50 percent or more of girls ages 13 through 17 in 23 states had received one or more doses according to Centers for Disease Control and Prevention data.

However, only in five states—Connecticut, Massachusetts, Rhode Island, South Dakota and Washington— had the majority of girls ages 13 through 17 completed the three dose series.

The data show that once girls have had one dose of the vaccine, they are likely to complete the series— with only Alabama showing full compliance less than 50 percent after the first vaccination.

CDC recommends that the same brand be used for all three doses for females.

The CDC and the American Academy of Pediatrics recommend the HPV vaccine for 11- and 12-year-old girls and also for teen girls and young women through age 26 who have not received the vaccine since 2006.1

CDC has not recommended that the vaccine be required for girls.

To date, no state has included HPV vaccination in state vaccination requirements, although several legislatures have debated the issue. Texas Gov. Rick Perry signed an executive order in 2007 to require the vaccine, but the legislature quickly overturned that order.

CDC estimated the retail price of the HPV vaccine, as of July 2011, was about $130 per dose, or $390 for the series.2

Most health insurance covers the cost of the vaccine.

The vaccine also is available through the federal Vaccines for Children program for those who are uninsured or whose insurance does not cover the cost of the vaccine.

In October 2011, the Advisory Committee on Immunization Practices recommended to the CDC that boys also be protected from HPV.3

The committee recommended males ages 11 and 12 be routinely vaccinated with three doses of the vaccine.

The vaccinations could begin as early as age 9 and males ages 13 to 21 who had not been vaccinated could receive the recommended three doses.

About 20 million Americans are infected with HPV.

Most people who become infected don’t even know they have it. In many cases, those infected do not develop any symptoms and the body’s immune system clears HPV naturally in about 90 percent of cases.4

HPV, however, is associated with several kinds of cancers and can cause genital warts in both men and women. Both approved HPV vaccines— Cervarix and Gardasil—prevent the types of HPV that cause cervical cancer in women.5 Gardasil protects against genital warts in women and has been shown to protect against anal, vaginal and vulvar cancers as well, according to the CDC.

Gardasil also protects males against most genital warts and anal cancers.